Dean: Dems 'In Deep Trouble' On Health Care, The Only Options Are A Bad Bill Or 2010 Losses

One of the leading progressive champions of health care reform is pessimistic about the state of the debate in the Senate, saying he sees virtually no path to passing strong legislation and predicting potential congressional losses for Democrats as a consequence.

Former DNC Chair Howard Dean told the Huffington Post on Monday that Senate Democratic leadership was "in deep trouble" on health care, even after Majority Leader Harry Reid cobbled together over the weekend the 60 votes needed to get legislation to the floor. The problem was as much about politics as policy.

"I think if you passed the Senate bill tomorrow it would be OK. But then the problem is they don't have any defense for their members in 2010," Dean said, noting that the public option would not become operational until 2014. "On the other hand, if they drop the public option [to placate moderate members], I think they lose seats."

"So this is really tough. I didn't anticipate being in this position. I thought it would pass. Maybe Harry has some magic up his sleeve. But I don't see how he gets those four votes [Sens. Joseph Lieberman (Conn.), Mary Landrieu (La.), Blanche Lincoln (Ark.) and Ben Nelson (Neb.)] without compromising the bill," Dean concluded.

The former Vermont governor warned that if the party allowed the four moderates to further water down the bill (or defeat it altogether) it could lead to primary challenges or a drop in fundraising from the party's base.

"If you have members refusing to vote for Reid on procedural issues you will have a revolt in the party," Dean said. "What is the point of having a 60-vote margin? This is going to be death for the [Democratic Congressional Campaign Committee] and the [Democratic Senatorial Campaign Committee]. Why would anyone donate to them if they're supporting candidates who defeat the Democratic agenda?"

There was, he insisted, an out clause. Reconciliation -- the budgetary maneuver that would allow portions of reform to be considered by an up or down vote -- "looks better every time," Dean said. "Someone has to say, at some point, we need to pass a bill." Reid has hinted that reconciliation is an increasingly unlikely proposition.

One of the loudest champions of a public plan, Dean has rarely expressed such pessimism about the state of play in the Senate. But even aides on the Hill admit that the path forward to gathering the 60 votes needed to stop a Republican filibuster is immensely challenging.

That said, Dean wasn't ready to read health care reform its final rites. And others who work on the progressive side of the debate said they are more bullish about the prospects of passing strong legislation. Richard Kirsch, national campaign manager for Health Care for America Now, said he noted that progressives in the Senate have been remarkably united in asserting their positions to Reid and indicating "that they won't be rolled by their more conservative members."

"Reconciliation is one of those things that is always there," Kirsch added. "It might not be the topic of conversation now. But it might go that way if four senators decide to wag the tail of the dog."

Celinda Lake, a Democratic pollster who has worked with HCAN and others on health care reform, was similarly upbeat. The goal, she said, was to keep the ball moving, pass legislation out of the Senate and then improve on its policy prescriptions once in conference committee with the House.

"The issue is to ensure that something is decent," said Lake. "I think the other thing is we need the president to weigh in, and I suspect he will weigh in very heavily in the conference committee."